Advertisement
Original article| Volume 88, ISSUE 5, P583-588, May 2007

Association of Mobility Limitations With Health Care Satisfaction and Use of Preventive Care: A Survey of Medicare Beneficiaries

      Abstract

      Hoffman JM, Shumway-Cook A, Yorkston KM, Ciol MA, Dudgeon BJ, Chan L. Association of mobility limitations with health care satisfaction and use of preventive care: a survey of Medicare beneficiaries.

      Objective

      To examine the association between satisfaction with health care, the use of preventive health care, and mobility limitation.

      Design

      Cross-sectional analysis of survey data.

      Setting

      Community.

      Participants

      A total of 12,769 people, age greater than 65, who participated in the 2001 Medicare Current Beneficiary Survey.

      Interventions

      Not applicable.

      Main Outcome Measures

      Self-report of mobility limitation, satisfaction, and use of preventive health care (immunizations, cancer screening). Sampling weights were used in all analyses, including logistic regression for survey data, to calculate estimates for a Medicare population of 31 million.

      Results

      After controlling for sociodemographic characteristics, Medicare beneficiaries with mobility limitations were significantly more dissatisfied with their health care compared with beneficiaries without mobility limitations. Receipt of preventive care did not differ for those with and without mobility limitation on some preventive services.

      Conclusions

      Mobility limitation is highly associated with dissatisfaction with health care among older adult beneficiaries. Although Medicare beneficiaries may receive similar rates of preventive care, those with mobility limitation may have more difficulty accessing services and be more dissatisfied with their health care in general.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Jha A.
        • Patrick D.L.
        • MacLehose R.F.
        • Doctor J.N.
        • Chan L.
        Dissatisfaction with medical services among Medicare beneficiaries with disabilities.
        Arch Phys Med Rehabil. 2002; 83: 1335-1341
        • Iezzoni L.I.
        • Davis R.B.
        • Soukup J.
        • O’Day B.
        Satisfaction with quality and access to health care among people with disabling conditions.
        Int J Qual Health Care. 2002; 14: 369-381
        • Hoffman J.M.
        • Yorkston K.M.
        • Shumway-Cook A.
        • Ciol M.A.
        • Dudgeon B.J.
        • Chan L.
        Effect of communication disability on satisfaction with health care: a survey of Medicare beneficiaries.
        Am J Speech Lang Pathol. 2005; 14: 221-228
        • Iezzoni L.I.
        • McCarthy E.P.
        • Davis R.B.
        • Siebens H.
        Mobility impairments and use of screening and preventive services.
        Am J Public Health. 2000; 90: 955-961
        • Chan L.
        • Doctor J.N.
        • MacLehose R.F.
        • et al.
        Do Medicare patients with disabilities receive preventive services?.
        Arch Phys Med Rehabil. 1999; 80: 642-646
        • Iezzoni L.I.
        • McCarthy E.P.
        • Davis R.B.
        • Harris-David L.
        • O’Day B.
        Use of screening and preventive services among women with disabilities.
        Am J Med Qual. 2001; 16: 135-144
        • Hupcey J.E.
        • Clark M.B.
        • Hutcheson C.R.
        • Thompson V.L.
        Expectations for care: older adults’ satisfaction with and trust in health care providers.
        J Gerontol Nurs. 2004; 30: 37-45
        • Iezzoni L.I.
        • Davis R.B.
        • Soukup J.
        • O’Day B.
        Quality dimensions that most concern people with physical and sensory disabilities.
        Arch Intern Med. 2003; 163: 2085-2092
        • Patla A.S.
        • Shumway-Cook A.
        Dimensions of mobility: defining the complexity and difficulty associated with community mobility.
        J Aging Phys Act. 1999; 7: 7-19
        • Dijkers M.P.
        • Whiteneck G.
        • El-Jaroudi R.
        Measures of social outcomes in disability research.
        Arch Phys Med Rehabil. 2000; 81: S63-S80
        • Iezzoni L.I.
        • McCarthy E.P.
        • Davis R.B.
        • Siebens H.
        Mobility difficulties are not only a problem of old age.
        J Gen Intern Med. 2001; 16: 235-243
        • Iezzoni L.I.
        • McCarthy E.P.
        • Davis R.B.
        • Siebens H.
        Mobility problems and perceptions of disability by self-respondents and proxy respondents.
        Med Care. 2000; 38: 1051-1057
        • Shumway-Cook A.
        • Ciol M.A.
        • Yorkston K.M.
        • Hoffman J.M.
        • Chan L.
        Mobility limitations in the Medicare population: prevalence and sociodemographic and clinical correlates.
        J Am Geriatr Soc. 2005; 53: 1217-1221
        • Guralnik J.M.
        • Simonsick E.M.
        • Ferrucci L.
        • et al.
        A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission.
        J Gerontol A Biol Sci Med Sci. 1994; 49: M85-M94
        • Fried L.P.
        • Bandeen-Roche K.
        • Chaves P.H.
        • Johnson B.A.
        Preclinical mobility disability predicts incident mobility disability in older women.
        J Gerontol A Biol Sci Med Sci. 2000; 55: M43-M52
        • Lawrence A.H.
        • Jette A.M.
        Disentangling the disablement process.
        J Gerontol B Psychol Sci Soc Sci. 1996; 51: S173-S182
        • Stuck A.E.
        • Walthert J.M.
        • Nikolaus T.
        • Bula C.J.
        • Hohmann C.
        • Beck J.C.
        Risk factors for functional status decline in community-living elderly people: a systematic literature review.
        Soc Sci Med. 1999; 48: 445-469
        • Chan L.
        • Beaver S.
        • MacLehose R.F.
        • Jha A.
        • Maciejewski M.
        • Doctor J.N.
        Disability and health care costs in the Medicare population.
        Arch Phys Med Rehabil. 2002; 83: 1196-1201
        • Adler G.S.
        A profile of the Medicare Current Beneficiary Survey.
        Health Care Financ Rev. 1994; 15: 153-163
        • Goldberg T.H.
        • Chavin S.I.
        Preventive medicine and screening in older adults.
        J Am Geriatr Soc. 1997; 45: 344-354
        • Smith R.A.
        • Cokkinides V.
        • von Eschenbach A.C.
        • et al.
        • American Cancer Society
        American Cancer Society guidelines for the early detection of cancer.
        CA Cancer J Clin. 2002; 52: 8-22
        • Ciol M.A.
        • Hoffman J.M.
        • Dudgeon B.J.
        • Shumway-Cook A.
        • Yorkston K.M.
        • Chan L.
        Understanding the use of weights in the analysis of data from multistage surveys.
        Arch Phys Med Rehabil. 2006; 87: 299-303
        • Kish L.
        Survey sampling. John Wiley & Sons, New York1995
        • Hosmer D.
        • Lemeshow S.
        Applied logistic regression. 2nd ed. John Wiley & Sons, New York2000
        • Linn L.S.
        Factors associated with patient evaluation of health care.
        Milbank Mem Fund Q Health Soc. 1975; 53: 531-548
        • Greenley J.R.
        • Young T.B.
        • Schoenherr R.A.
        Psychological distress and patient satisfaction.
        Med Care. 1982; 20: 373-385